Chest
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Chest radiography (CXR) often is performed in the acute setting to help understand the extent of respiratory disease in patients with COVID-19, but a clearly defined role for negative chest radiograph results in assessing patients has not been described. ⋯ Initial CXR in adult patients suspected of having COVID-19 is a strong exclusionary test for hospital admission, mechanical ventilation, ARDS, and mortality. The value of CXR as an exclusionary test for adverse clinical outcomes is highest among young adults, patients with few comorbidities, and those with a prolonged duration of symptoms.
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A 72-year-old woman, nonsmoker, presented with approximately 2 months of nonproductive cough. The cough was initially intermittent, occurred more regularly during bedtime, but gradually became more frequent throughout the day with no reported triggering factors. The remaining review of associated symptoms was negative; she did not complain of shortness of breath, fever, chest pain, muscle weakness, weight loss, night sweats, or fatigue. ⋯ Patient was free of disease on follow up from her endocrinologist, to optimize levothyroxine treatment. Her regular prescription included statins. Her professional occupation was not related to special exposure, and she reported no alcohol consumption, illicit drug use, or any recent travel.
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Hormone replacement therapy (HRT) is prescribed to millions of women worldwide. Previous studies have suggested that HRT has both protective and harmful effects in asthma. ⋯ HRT seems to play a role in the development of asthma in mature women. Clinicians prescribing HRT and women receiving HRT should be aware that new airway symptoms can develop, and discontinuation of HRT should be considered.
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Among patients successfully resuscitated after an out-of-hospital cardiac arrest (OHCA), 10% to 15% evolve toward brain death (BD), thus becoming potential organ donors. ⋯ ClinicalTrials.gov; No.: NCT01595958, and ClinicalTrials.gov; No.: NCT00999583; URL: www.clinicaltrials.gov.